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IPA Encourages Action on DIR

The years-long effort by IPA and our national partners to build support for a proposal to eliminate retroactive DIR fees may soon come to fruition. 

The years-long effort by IPA and our national partners to build support for a proposal to eliminate retroactive DIR fees may soon come to fruition. Recently, IPA participated in several initiatives to build support for parts of a proposed Centers for Medicare and Medicaid Services (CMS) drug pricing rule that would eliminate the retroactive nature of pharmacy DIR fees. This proposed rule would provide needed relief from the dire impact pharmacy DIR fees have had on patient's out-of-pocket costs and small business community pharmacies.

The proposal would change the definition of negotiated price concession to force PBMs to include all pharmacy price concessions (aka pharmacy DIR) at the point of sale. It also redefines the term "price concessions" to embody only types of pharmacy DIR that a pharmacy would encounter in a PBM contract. While the rule change doesn't eliminate DIR fees altogether, it is certainly a step toward complete elimination and progress with CMS.

IPA signed on to a joint letter with the National Community Pharmacists Association (NCPA) and National Association of Chain Drug Stores, and 150 pharmacy stakeholder organizations, to Secretary of the U.S. Department of Health and Human Services Alex Azar and CMS Administrator Seema Verma urging them to support the proposal.

IPA also submitted a separate letter to voice support and encourage the administration to finalize the proposal. Along with IPA, nearly 3,500 pharmacists and 170 patients formally voiced their support for parts of the rule during the public comment period, which closed on Jan. 25. Several letters supporting the proposed DIR fixes are also being sent by members of Congress.

CMS will now review all the public comments that were submitted and a final rule is expected to be released sometime in April. Thank you to all IPA members who participated in this massive demonstration of support. 

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